Some 6,700 long-term care providers were interviewed for the study, which also examined a trend that’s emerging in the field: the ways in which providers are adding on transportation, extra meals and other services to their fee structures. Those add-on services are making decisions more complicated for families mulling over the care a family member might need, the Journal reported.

For purposes of the study, the Journal reported, long-term care services included health and daily living assistance that’s provided in facilities or in people’s homes.

In the last five years, for instance, the average rent at assisted living facilities offering six to nine services rose 17 percent to $3,486, according to the study. The good news: Costs for home health aides and adult-day services didn’t rise, on average.

But to add some perspective, the Journal cited a recent report that showed home health care spending by Medicare beneficiaries skyrocketed 129 percent to $19 billion from 2000 to 2010.

The rise in health care costs, and in long-term care insurance, is no surprise to policyholders grappling with rising premiums. According to Jane Bryant Quinn, the long-term care insurance market is squeezing out the middle class as costs rise beyond what people can afford.

The number of new individual buyers dropped by 43 percent between 2004 and 2009 and has recovered only slightly since, Quinn reported.

The cost for new policies for people 55 to 65 rose by as much as 50 percent compared with five years ago. Quinn recommended that people buy or renew long-term care insurance only if they can afford it.